Abstract 13135: Association of Three-Dimensional Tricuspid Valve Deformation With Functional Tricuspid Regurgitation

Abstract

Introduction: Background: Functional tricuspid regurgitation (FTR) is widely recognized as being associated with poor outcomes in patients with various cardiac diseases, and the tricuspid valve (TV) deformation is an important mechanism of FTR. However, the precise assessment of TV deformation by means of two-dimensional echocardiography is limited. Purpose: The purpose of this study was thus to investigate the association of TV deformation with FTR by using three-dimensional transthoracic echocardiography (3D-TTE). Methods: We studied 65 patients with FTR. Their mean age was 60±16 years and 36 patients (55%) were female. FTR was quantified by the ratio of the jet area and corresponding RA area, and more than moderate FTR was defined as significant. 3D-TTE was performed to analyze the tricuspid deformation. Tricuspid tenting height and area were analyzed at the time of maximal systolic closure. TV area index, anterior-posterior (A-P) and septal-lateral (S-L) TV annular diameters were analyzed at end-diastole. Right ventricular longitudinal length, end-diastolic and end-systolic area index (EDAI, ESAI) and right atrial area index (RAA) were also obtained from 3D data set. Results: Twenty-one patients were classified as having significant FTR. Tenting height (6.5±3.1 vs. 4.0±1.8 mm, p<0.001), tenting area (1.3±0.8 vs. 0.7±0.4 cm2, p=0.003), TV area (6.9±1.7 vs. 5.0±1.4 cm2/m2, p<0.001) and S-L (35±4 vs. 28±6 mm, p<0.001) in patients with FTR were significantly larger than those in patients with non-significant FTR, but A-L was not (38±6 vs. 36±7mm). After adjusting for age, ESAI, RAA and tenting height, a multivariate logistic regression analysis showed that TV area (odds ratio 3.1, p=0.04) was independently associated with significant FTR. Conclusions: TV-related parameters were associated with FTR, and TV area was the most important factor for FTR. Our findings by means of 3D-TTE may well have clinical implications for better management of patients with FTR.